ESTUDYR
NCLEX-RN Case Study: Cirrhosis with Hepatic
Encephalopathy
Client Scenario
0800 Nurses' Notes:
A 54-year-old male with a long history of chronic Alchohol Use Disorder and Hepatitis C is
admitted to the medical-surgical unit. His family states he has been increasingly "confused
and sleepy" over the last two days. They also noticed his abdomen is significantly larger, and
he has a yellowish tint to his skin.
Physical Assessment:
Neuro: Disoriented to time and place. When asked to hold his arms out, his hands
perform a rhythmic "flapping" motion.
Integumentary: Jaundice noted in the sclera and skin. Multiple spider angiomas on
the chest.
Abdominal: Distended with a positive fluid wave; caput medusae (visible veins)
noted around the umbilicus.
Vital Signs: BP 108/62, HR 96, RR 18, Temp 98.4°F.
Item 1: Recognizing Cues
Question: Click to highlight the findings that require immediate intervention or monitoring
for safety.
Findings: 54-year-old male; increasingly confused and sleepy; hands perform a rhythmic
"flapping" motion; Disoriented to time and place; Jaundice; Abdomen distended with a
positive fluid wave; BP 108/62.
Correct Selections:
✅Increasingly confused and sleepy (Sign of worsening encephalopathy/potential
coma)
NCLEX-RN Case Study: Cirrhosis with Hepatic
Encephalopathy
Client Scenario
0800 Nurses' Notes:
A 54-year-old male with a long history of chronic Alchohol Use Disorder and Hepatitis C is
admitted to the medical-surgical unit. His family states he has been increasingly "confused
and sleepy" over the last two days. They also noticed his abdomen is significantly larger, and
he has a yellowish tint to his skin.
Physical Assessment:
Neuro: Disoriented to time and place. When asked to hold his arms out, his hands
perform a rhythmic "flapping" motion.
Integumentary: Jaundice noted in the sclera and skin. Multiple spider angiomas on
the chest.
Abdominal: Distended with a positive fluid wave; caput medusae (visible veins)
noted around the umbilicus.
Vital Signs: BP 108/62, HR 96, RR 18, Temp 98.4°F.
Item 1: Recognizing Cues
Question: Click to highlight the findings that require immediate intervention or monitoring
for safety.
Findings: 54-year-old male; increasingly confused and sleepy; hands perform a rhythmic
"flapping" motion; Disoriented to time and place; Jaundice; Abdomen distended with a
positive fluid wave; BP 108/62.
Correct Selections:
✅Increasingly confused and sleepy (Sign of worsening encephalopathy/potential
coma)
